Non-foveal macular holes after PPV for macular pucker

To describe six patients [six eyes] who developed an eccentric macular hole after surgery for idiopathic epimacular proliferation. Review of records from six patients who developed eccentric macular holes postoperatively following vitrectomy in 107 consecutives cases with peeling of the epimacular proliferation and internal limiting membrane [ILM] from June 2004 to January 2009. Eccentric macular holes were developed from nine days to eight months [mean, 3.1 months] after epimacular proliferation peeling. The ILM was peeled in addition to the epimacular proliferation in five of the six cases. Of the six eccentric macular holes, four were located temporal to the fovea, one was located superior to the fovea, and one was located nasal to the fovea. Final visual acuities after a mean follow-up period of 17.3 months were 20/20 in two eyes, 20/25 in one eye, 20/40 in two eyes, and 5/200 in one eye. The eye with eccentric macular hole nasal to the fovea had the poorest final visual acuity of 5/200. Eccentric macular holes occurring after vitrectomy to remove epimacular proliferation is an uncommon postoperative finding. Various explanations have been suggested for the etiology of these holes, but there is no consensus. We suggested that the ILM tear should be initiated with a diamond dusted knife to reduce the likelihood of injury to the underlying Muller cells that may contribute to the formation of eccentric macular holes

Angioimmunoblastic lymphadenopathy with dysproteinemia complicated by pancytopenia

Angioimmunoblastic lymphadenopathy with dysproteinemia [AILD] is described. The patient had generalised lymphadenopathy, skin rash and hepatosplenomegaly. Serum IgA level was raised. Lymphnode biopsy showed effacement of its architecture, infiltration by numerous immunoblast and plasma cells and abundant proliferation of arborising small blood vessels. After initial improvement on steroid, the patients 's general condition deteriorated and he developed pancytopenia and died